How to Best Communicate with Legislators

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PASSE: Take Action!


The PASSE system was voted in by our legislature last year. Right now, we’re in what they call “Phase I,” and during that time, the PASSEs will manage care for their clients, but Medicaid will keep paying the bills. Then in January 2019, we move into “Phase II,” and the PASSEs’ decisions about our care will matter. In January, DHS/Medicaid will give the PASSEs the money and allow them to decide how to use it.


If you need a reminder, the PASSE stands for Provider-led Arkansas Shared Savings Entity, and like insurance companies, they will be covering the care for tiers 2 & 3, what DHS considers to be higher level need, of behavioral health and developmental disability services.

DHS has assigned thousands of people to the 4 licensed PASSEs after each person’s Independent Assessment completion. If you are affected, you will likely first receive a letter or some sort of notification to schedule an Independent Assessment.

If you have questions, DHS has a PASSE counseling line: 1-833-402-0672. They also have regional people you can talk to.

MSL is actively working to get you more information on the PASSEs themselves. Now that details are coming together, we should be able to get more. The information we have so far is listed below in steps that should help you.


These changes may be happening to you or a loved one, but you can do these 8 things to help yourself in this new process:

1. Make sure your provider knows about the PASSE and everything it involves.

It’s important that you ask your provider to join every PASSE. What if next year, you need to switch PASSEs because of a bad experience, but your provider isn’t in any other PASSE? If they choose to join only one PASSE, you could be forced to make a decision between 2 (or more) providers you really like. What if your trusted Cardiologist who did your surgery is in only one PASSE and your Therapist who you’ve been with for years is only in another? You might have to choose. However, even after you ask your provider to join all PASSEs, they may still choose to join only one because they have invested in that PASSE or simply because it’s a business decision. They have that right, but you still have to look out for what’s best for you; for the people whose care and services will be managed by the PASSEs, it’s best for us to have as much choice and freedom as possible. The only way you can have that is when providers give you choices by joining all PASSEs. Some PASSEs have said they will pay for out-of-network costs or make special agreements, but that’s probably only for providers you don’t see often.

DHS said that they are in the process of setting reimbursement rates for providers – the actuary process. Because of that, some providers will not know what you mean when you mention the PASSE to them. Their business office may know and may be waiting on these rates before making any decisions. However, you can still take this information to your provider and/or to the business office.

The following packets are ones that DHS has distributed to providers. Don’t assume yours has received it. Every provider you use needs to be sure they understand this info about the PASSEs. The last is a collection of contact information of all PASSEs specifically for providers to help them join. Take care of yourself, and take these to every provider you see.

  • A Family letter to take to your providers that explains this for you
  • Resource that was sent to PCPs
  • Resource that explains PASSEs Phase I
  • Resource that explains PASSE Phase II and updates
  • Resource for providers that explains why and how to join
  • Give them the contact information below

Some have been concerned whether ACH is covered. This is the response:

“State supported hospitals UAMS and ACH will be enrolled with every PASSE. Many doctors are enrolled through their networks but may not know that yet. You can call every PASSE and interview them so you are making an informed choice.”


2. Get to know the PASSEs.

*MSL has requested websites for all – check back for updates.

Arkansas Total Care
Empower
Summit (Arkansas Provider Coalition)
  • Amerigroup Partnership Plan LLC
  • http://www.summitcommunitycare.com
  • Their HANDBOOK (rules, your rights, and information)
  • Network Provider Directory
  • Jason Miller
    Jason.miller@summitcommunitycare.com
  • 425 W. Capitol Ave. Suite 233 | Little Rock, AR 72203
  • 1-844-405-4295
ForevercARe

3. Join a PASSE Advisory Committee.

Each PASSE is required by Act 775 (pg 9, line 21) to have a Consumer Advisory Council to give them feedback. They know how things are supposed to happen, but it’s up to you to keep them informed of what’s really happening.

Call your care coordinator to join your PASSE’s council.


4. Remember, you have choices.

Once you have been assigned a PASSE, you have 90 days to change to another. Call your PASSE, and make sure they include your providers. If they don’t, use the info above to find a PASSE that better suits you. DHS is also going to offer open enrollment in October 2018. We will continue to provide more info as we can!

Also, DHS will have open enrollment in March 2019 for all current members. During that time, you will be allowed to switch to another PASSE, and by then, we should know more.


5. If you don’t agree with your assessment results, which you should receive in the mail, know you can appeal.

You have rights, and you can appeal DHS decisions. This is a very new process, and assessors can make mistakes. Check this post to see what your rights are and how to file an appeal. Watch our Q & A with Disability Rights where we answered common questions.


6. If you feel lost, take some time to catch up.

What is a PASSE? Will you be affected? MSL has been following the PASSE from the very beginning. Take some time to catch up and read all about them.


7. Keep MSL informed.

If you learn anything, especially from a specific PASSE, share it with us! If you have any problems, MSL works to solve those for you. Please let us know by:


8. Think about how you’re feeling now, remember that at the next vote.

Our legislature voted this into effect. We called, we emailed, and we visited – all to let them know what we need. If you feel that this good for you, remember that, and perhaps send a note to let them know. You might want to vote for your representatives again. If you feel they didn’t listen to you or didn’t represent you well by voting for this, you should send them a letter to let them know. However, you also have the power to change who is in office. Make sure you place an informed vote. See how your local Representatives or Senators voted on Act 775.

How to Register to Vote

Wikihow has all the info on how to register to vote in Arkansas!

“Registering to vote in Arkansas is simple. However, you do need to meet certain requirements. For instance, you must be a U.S. citizen, an Arkansas resident for at least 30 days, and 18 years old on or before the election. Additionally, you must be discharged or pardoned from all convicted felonies. You can register in Arkansas by mailing in your application. You can also fill out an application in person by visiting an approved institution like your county clerk’s office or your local public library.”

Find out more!

AR Choices Update

It’s been over a month since Legal Aid’s last update. After a period of relative quiet, here’s the latest from Kevin De Liban on the ARChoices program. Please note the upcoming legislative committee hearings listed below on 9/13 and 9/18.


(1) Public comments. In July, many people showed up to the public hearings or wrote DHS with comments. Those comments are attached to this email. Though the comments were overwhelmingly against the algorithm, DHS plans to go ahead and start using the RUGs algorithm again in the exact same way as they did before starting on 10/1/18.

RUGs changed the effective limit of attendant care from 8 hours per day to 5.5 or 6. This has not been enough for Legal Aid’s clients. On top of that, the algorithm is nearly impossible to understand, has had multiple software errors, and doesn’t take into account a doctor’s opinion or consider the actual amount of time it takes to provide care to someone on the program.

(2) The legislature is considering the RUGs algorithm this Thursday, 9/13, and next Tuesday, 9/18.  DHS is presenting the algorithm to two separate legislative committees in the next week. Apparently, if the Public Health Committee does not approve it, the algorithm may be delayed or stopped.

Thursday, 9/13, 10 a.m., Public Health Committee, Room A of the MAC Building. I have been told that public comment will be accepted. People who attend must sign in on a sheet to request to speak.

Tuesday, 9/18, 1 p.m., Rules and Regulations Subcommittee, Room A of the MAC Building. I have been told that public comment will be accepted. People who attend must sign in on a sheet to request to speak.

It is not clear that the legislators on these committees will have seen the comments that were submitted to DHS. So, they may not know that most people are against the algorithm. The legislators may not have any source of information other than what DHS tells them. The meetings are open to the public, and I have been told that public comment will be accepted. 

(3) DHS resumed assessments, but only for personal care (not attendant care). People already on the program still cannot get adjustments to their attendant care hours. People who’ve applied for the program are unable to get any attendant care at all. But, after we filed our ongoing lawsuit on behalf of an ARChoices applicant who was denied all services, DHS started determining applicants’ program eligibility and giving them up to 14.5 hours per week of personal care (NOT attendant care, which is slightly different). This isn’t anywhere near enough for many applicants. The lawsuit is continuing and seeks to force DHS to use the prior system of nurse discretion to allocate attendant care until a new valid method is in place.

(4) New Algorithm. As far as we know, DHS is still planning to switch to a new algorithm and new assessment system for ARChoices. This will be based on the same assessment system that is currently in use for personal care, behavioral health, and the development delay waiver. DHS has not provided a timeline for the new algorithm, but, based on the legal timelines required, the new algorithm is not likely to be put into place before 2019.

As always, if you have any questions, please feel free to write me here or call me at my office (800-967-9224 x 2206).

Contact:

Kevin De Liban, Attorney

Economic Justice Practice Group Leader

Legal Aid of Arkansas–West Memphis

310 Mid-Continent Plaza, Suite 420

West Memphis, AR 72301

Phone: (870) 732-6370 x. 2206

AR Works: Urgent News

Today (September 5) is the day!

If you’re on ARWorks and have not reported your work, school, or some exemptions for the past 3 months, you will lose your coverage after today.

DHS says they have sent multiple notices, yet still we’re hearing news reports that thousands will lose their coverage because they haven’t responded. Unfortunately, these people will not be allowed to reapply until January 2019.

If you are one of these people, you need to report TODAY. If you know someone who is affected, you need to share this with them!

Find out a great update and tips from Legal Aid!

Here are some resources from DHS all in one place to help you know what to do:

Call your insurance provider if you don’t have internet regularly enough to report!

Plus here are some videos to help you know how to get an account and report your activities.

Watch DHS’ Facebook Live where they answered questions we sent in.

Call for help at 1-855-372-1084!

Make sure to pass this info on to anyone who might not realize they are going to lose their coverage after September 5, 2018. This only applies to certain people on ARWorks, so log in and make sure you’re safe.

How to Make a Public Comment Before Sept. 12, 2018

DHS notified the public of some proposed rule changes on several issues. You have the opportunity to take action and make a public comment until September 12, 2018 on those documents. How would one choose to make a public comment about the many issues that are changing? Watch the video for more details!

This is how you can place your own public comment for the record:

1. First, follow this link (copy and paste it into your internet address window): https://medicaid.mmis.arkansas.gov/General/Comment/Comment.aspx

2. You will see some documents on a long page that are available for public comment by September 12, 2018. The documents you want look just like the ones in the graphic below. The ones in the long section on bottom are old, and the date has passed.

3. You will want to view the documents. Click on the blue link with that name (on the Medicaid website), and it will download the file for you.

4. Open the file from your document downloads, if it doesn’t open automatically for you.

5. At first glance, it may be difficult to understand, but try to read through it as best as you can. You might understand more than you think.

6. After you read through it, you might want to send in some comments about how this will affect you. For example in the PASSE manual, you might want to comment on what the PASSE is required to cover.

7. You can choose to mail your comments, but the faster way is by email. You can send your comments in an email to becky.murphy@dhs.arkansas.gov, but be sure to reference which manual you’re commenting on in the subject line.

8. Make sure to do this before September 12, 2018!

9. You can also choose to go to a public comment and say your comments there:

AR Works: Update from Legal Aid

Legal Aid of Arkansas sent the following update and wants everyone to know this important information.


We’re writing to let you know the latest information on the work requirements in the Arkansas Works program. With the work requirements now in effect, Legal Aid is available to help beneficiaries understand how to comply and how to assert their legal rights. Anyone affected is welcome to call our special Medicaid line–(800) 967-9224 and press 4. 

Lawsuit: Because of the widespread loss of coverage these work requirements are likely to cause for our clients, Legal Aid of Arkansas has filed a federal lawsuit in Washington DC. While that lawsuit is moving along, we want to make sure people have all the information they need to give them the best chance of keeping their coverage.

Letters of Non-ComplianceMany beneficiaries will have already received notices for non-compliance for the month of July. The notices will have a date of August 6 on them. For some people, this is their second month of non-compliance, and they will be terminated as of September 1 if they do not report compliance in August. For others, this is just the first month of non-compliance, but that means their care is threatened for future months. DHS reported that 72% of people who had to go online in June did not do so. That’s about 7,400 people, and we expect similar numbers for July, which are set to come out later this week.

Resources for People AffectedAnyone who receives notices of non-compliance is welcome to call Legal Aid for information about the program and their legal rights. We have a special Medicaid line–just call (800) 967-9224 and press 4. If someone doesn’t answer right away, we’ll get back with them within a few business hours. You (or they) are also welcome to call me at x. 2206 or Trevor Hawkins at x. 6313.

Here are other ways you can spread the word about the changes: 

(1) Share the Facebook video. This explains the latest on the lawsuit and how to comply with the work requirements:  https://www.facebook.com/arlegalaid/videos/2110260212381560/

(2) Share the flyer

and this (Front/back) handout. 

(3)  Invite us to talk to  your group, community, staff, or clients. We can accommodate any form of participation (in-person, video, phone), various languages, and any time limitations.

Contact:

Kevin De Liban, Attorney

Economic Justice Practice Group Leader

Legal Aid of Arkansas–West Memphis

310 Mid-Continent Plaza, Suite 420

West Memphis, AR 72301

Phone: (870) 732-6370 x. 2206

Fax: (870) 732-6373

Facebook Twitter

Happy Birthday, Medicaid!

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On July 30, 1965, President Lyndon Johnson signed Medicare and Medicaid into law. For 53 years, it has served as a safety net for millions of people in times of health and financial hardship.

Let’s celebrate Medicaid by sharing why you’re thankful for it! What has Medicaid done for you, a friend, or a loved one?

Note: Many of these may be shared, so you don’t have to put your whole name. You can include a link to your photo, such as one you’ve shared publicly on your social media profile.